OSHA watch

Anti-retaliation provisions of electronic record-keeping rule survives employer challenge

An Occupational Safety and Health Review Commission (OSHRC) administrative law judge’s decision to reject two defenses offered by the U.S. Postal Service to a citation preserves the controversial anti-retaliation provisions under its electronic record-keeping rule. The USPS allegedly issued a seven-day working suspension to a carrier because he reported a work-related injury. The USPS argued that the alleged standard and/or penalties were invalid because they were beyond the legal power or authority of OSHA and/or were arbitrary and capricious.

Process Safety Management standard extended beyond hazardous chemicals in ruling

Legal experts warn that a recent OSHRC ruling regarding safety violations in a deadly oil refinery explosion in 2012 could have wider implications for companies dealing with highly hazardous chemicals. OSHRC affirmed 12 violations of Process Safety Management standard by Wynnewood Refining Co, which argued the PSM was never intended to include processes that do not manage such chemicals – such as the steam boiler involved.

Prior to this ruling, it was widely understood that utilities unrelated to the manufacturing process were not included in the requirements for PSM. Experts say it is unclear how far the standard extends now.

Social media campaign to educate young workers

#MySafeSummerJob, a social media campaign to educate young workers about their rights in the workplace, how to speak up about dangerous work conditions, and how to protect themselves on the job, was launched in concert with several worker safety organizations. From April 15 through May 17 outreach will promote safety among young workers. Check out materials and ideas at the #MySafeSummerJob website.

Regional construction safety campaign shifts focus to falls

In concert with the Mid-Atlantic Construction Safety Council, a four-month campaign was launched to address the four leading causes of fatal injuries in construction. In March, the campaign focused on electrical hazards, and during April the emphasis was on struck-by hazards. This month is falls, and caught-in / between hazards will be the focus in June. The campaign serves employers and employees in Delaware, the District of Columbia, Maryland, Pennsylvania, Virginia, and West Virginia.

Email OSHA-Focus4-Region3@dol.gov for more information.

OSHRC finalizes revisions to its procedural rules

The OSHRC has finalized what it calls “comprehensive” revisions to its procedural rules, in part to reflect technological advances. Slated to take effect June 10, the changes include mandatory electronic filing for “represented” parties and a new method intended to streamline calculating time periods.

Proposal to watch: joint employer revisions

The Department of Labor announced a proposal to “revise and clarify” the issue of joint employers. The department is proposing a four-factor test “based on well-established precedent” that would consider whether the potential joint employer actually exercises the power to hire or fire the employee; supervise and control the employee’s work schedules or conditions of employment; determine the employee’s rate and method of payment; and maintain the employee’s employment records.

The proposal could differ from the interpretations put forth by other federal agencies and would not nullify regulations promulgated by individual states that have different standards.

The public has 60 days from April 1 to comment on the proposal.

Webpage on radiation emergency preparedness and response launched

A webpage intended to educate workers about how to protect themselves in radiation-related situations ranging from a small, isolated spill in a laboratory to a potentially catastrophic release at a nuclear facility is now live. The Radiation Emergency Preparedness and Response webpage provides resources on health and safety planning, medical monitoring and dosimetry, and other relevant topics for workers “who may be impacted by radiation emergencies” or “who may be involved in emergency response operations or related activities.”

Cal/OSHA proposing to re-adopt emergency rules for e-filing injury reports

Emergency rules were adopted Nov. 1, 2018 and the re-adoption would give additional time to proceed with regular rulemaking on a permanent basis. In addition to requiring electronic reporting for companies with at least 250 workers, the rules require businesses with 20 to 249 employees in industries such as construction, manufacturing and agriculture to electronically file injury logs.

A notice for proposed permanent rules is expected to be published by May 10.

MIOSHA launches emphasis program on roadway accident

The state emphasis program on roadway accidents will run through December 31, 2019 and is intended to increase the priority of inspections related to construction roadway safety and initiate inspections upon observing a roadway project with workers present.

Enforcement notes

California

  • Cal North Farm Labor Inc., a farm labor contractor and Crain Walnut Shelling Inc. face more than $100,000 combined in proposed penalties after a worker was fatally crushed by a bin dumper at a walnut processing and packing facility in Los Molinos.
  • Staffing agency Priority Workforce Inc. and JSL Foods Inc., a maker and distributor of pasta and baked goods face more than $300,000 in fines for serious citations after a temporary worker lost two fingers cleaning machinery at a Los Angeles food manufacturing facility.
  • Accurate Comfort Systems Inc. received four citations and faces $75,750 in penalties after a worker suffered serious injuries in a fall from a ladder on a 12-foot-high work area.

Florida

  • Inspected as part of the Regional Emphasis Program on Falls in Construction, Florida Roofing Experts, Inc. faces $132,598 in fines after inspectors observed workers performing residential roofing activities without fall protection.

Georgia

  • Investigated under the National Emphasis Program on Trenching and Excavation, Riverside Military Academy Inc., a military college preparatory academy in Gainesville, was cited for exposing employees to trenching hazards, faces $381,882 in penalties, and was placed in the Severe Violator Enforcement Program. Citations included allowing employees to work inside a trench without cave-in protection and a safe means to enter and exit the excavation, and failing to locate underground utilities prior to work.
  • Specialty chemical manufacturer, Plaze Aeroscience, operating as Plaze GA, was cited for exposing employees to fire and burn hazards at the company’s facility in Dalton and faces $107,164 in penalties.

Michigan

  • Mt. Clemens-based Powder Cote II received seven citations and faces $65,000 in penalties for failing to provide fall protection or guardrail systems, guard rotating shafts and machinery, and failing to control the startup of machinery during maintenance.

New York

  • Remington Arms, LLC, based in Madison, North Carolina was cited for 27 violations of workplace safety and health standards and faces $210,132 in penalties after a worker’s fingertip was amputated while using an unguarded metalworking machine at its Ilion manufacturing plant.

Pennsylvania

  • Framing contractor, Navy Contractors, Inc. was cited for willfully exposing employees to fall hazards at residential construction sites in Royersford, Collegeville, and Center Valley after inspections saw employees working without fall protection. The company faces $603,850 in penalties.
  • A jury in the U.S. District Court for the Eastern District has found that Lloyd Industries Inc., a manufacturing company based in Montgomeryville, and its owner William P. Lloyd unlawfully terminated two employees because of their involvement in a safety investigation. Damages will be determined in phase 2 of the trial.
  • A jury has concurred with the findings of a whistleblower investigation and awarded $40,000 for lost wages, pain and suffering, and punitive damages to a former employee of Fairmount Foundry Inc. The employee claimed that the Hamburg iron-casting company terminated him for reporting alleged safety and health hazards.
  • New Jersey contractor, Brutus Construction, Inc. was cited for exposing workers to fall hazards at a Souderton residential construction site. Inspectors saw employees working on roofs without fall protection and the company faces nearly $182,000 in penalties.

Wisconsin

  • A follow-up inspection revealed that Beloit-based Avid Pallet Services, LLC, failed to correct violations related to wood dust and respiratory hazards. The company faces penalties of $188,302.

For additional information.

For Cutting-Edge Strategies on Managing Risks and Slashing Insurance Costs visit www.StopBeingFrustrated.com

Ten most dangerous jobs

Going by the sheer number of on-the-job deaths, the truck drivers and sales drivers classification was by far the most dangerous, accounting for nearly 1,000 (987) deaths in 2017. However, the chances of a fatality are much higher in specific industries when the fatal work injury rate, calculated per 100,000 full-time equivalent workers, is used. According to a recent report in EHS Today, the ten most dangerous jobs of 2019 are:

No. 1 – Fishers and related fishing workers

Moving up from number 2 to become the most dangerous profession, fishers and related fishing workers experienced 41 fatalities in 2017, an increase of almost 58% from 2016. The fatality rate was 99.7 per 100,000 full-time equivalent workers. Risks: drowning, struck by lightning, crushed by equipment.

No. 2 – Loggers

Falling from the most-dangerous profession to number 2, loggers experienced 55 fatalities, a drop of almost 65% from 91 fatalities in 2016 for a fatality rate of 84.3. Risks: falls, struck-by, dangerous tools such as chainsaws and axes.

No. 3 – Aircraft pilots and flight engineers

Pilots and flight engineers experienced 59 fatalities in 2017 for a fatality rate of 58.6, a drop from 2016. Risks: crashes.

No. 4 – Roofers

Roofers experienced 91 fatalities in 2017 for a fatality rate of 45.2, slightly lower than in 2016. Risks: falls, struck-by, and heat.

No. 5 – Refuse and recyclable material collectors

Refuse and recyclable material collectors experienced 30 fatalities in 2017 for a fatality rate of 35.0, very similar to 2016. Risks: dangerous machinery, crushed by equipment, struck-by, traffic accidents, struck by vehicle.

No. 6 – Structural iron and steel workers

Steel and ironworkers experienced 14 fatalities in 2017 for a fatality rate of 33.4, a slight decrease from 2016. Risks: falls, struck-by, heat, crushed by materials.

No. 7 – Truck drivers and other drivers

Employees who drive for work – including truck drivers – experienced 987 fatalities in 2017 for a fatality rate of 26.8 out of 100,000 workers, which was higher than in 2016. Risks: traffic accidents, struck by vehicle, other drivers, construction zones, sleep deprivation, texting/talking while driving.

No. 8 – Farmers, ranchers, and agricultural managers

Agricultural workers experienced 258 fatalities in 2017 for a fatality rate of 24.0 out of 100,000 workers, very similar to 2016. Risks: dangerous machinery, chemicals, heat.

No. 9 – Grounds maintenance workers

Grounds maintenance workers experienced 244 fatalities in 2017 for a fatality rate of 21.0, a decline from 2016. Risks: heat, cold, noise, chemical exposure, ergonomics-related issues, machinery.

No. 10 – Electrical power-line installers and repairers

New to the list, electrical power-line installers and repairers experienced 26 fatalities for a fatality rate of 18.7. Risks: electrocution, falls to a lower level, transportation incidents.

Supervisors of construction workers (which ranked at #9 last year), fell off the list of the top 10.

Other key findings:

  • There were a total of 5,147 fatal work injuries recorded in the United States in 2017, down slightly from the 5,190 that were registered in 2016.
  • Fatal falls were at their highest level in the 26-year history of the Census of Fatal Occupational Injuries (CFOI), accounting for 887 (17 percent) worker deaths.
  • Transportation incidents remained the most frequent fatal event in 2017 with 2,077 (40 percent) occupational fatalities.
  • Violence and other injuries by persons or animals decreased 7 percent in 2017 with homicides and suicides decreasing by 8 percent and 5 percent, respectively.
  • Unintentional overdoses due to non-medical use of drugs or alcohol while at work increased 25 percent from 217 in 2016 to 272 in 2017. This was the fifth consecutive year in which unintentional workplace overdose deaths have increased by at least 25 percent.
  • Fatal occupational injuries involving confined spaces rose 15 percent to 166 in 2017 from 144 in 2016.
  • Crane-related workplace fatalities fell to their lowest level ever recorded in CFOI, 33 deaths in 2017.
  • Fifteen percent of the fatally-injured workers in 2017 were age 65 or over – a series high. In 1992, the first year CFOI published national data, that figure was 8 percent. These workers also had a higher fatality rate than other age groups in 2017.

For Cutting-Edge Strategies on Managing Risks and Slashing Insurance Costs visit www.StopBeingFrustrated.com

Employee behavior and heat-related illness: 5 problem-solutions

Educational campaigns and accessible resources coupled with technology and meteorology precision have made it possible for employers to provide site-specific weather information and the proper resources and training for employees to combat the risk of heat exposures. Tools such as OSHA’s heat index app calculate the heat index for the worksite, display a risk level for workers, and provide reminders about the protective measures that should be taken at that risk level.

Yet, every year thousands of workers suffer from heat illness and some die. Why?

In some cases, it’s organizational factors such as indifferent or callous supervision, poor workplace conditions, and unrealistic production expectations, which reflect the company’s overarching culture. Yet, many employers are proactive and do an excellent job in training employees and implementing procedures to prevent heat stress that aren’t followed by some employees.

Here are five problem-solutions related to employee behavior and heat stress:

  1. Problem: Risk perceptionSome employees simply underestimate how serious heat illness can be. They’ve worked in the heat before without incident – been there, done that – can’t happen to them. Moreover, the symptoms of heat illness can be subtle and misinterpreted as mere annoyances rather than signs of a serious health issue.

    That’s why the American Society of Safety Engineers calls heat the “unseen danger” at construction sites. If a heat rash appears or a cramp develops, workers can dismiss them as an inconvenience and continue working without applying a powder or getting water or a sports drink. Even signs of heat exhaustion such as thirst, heavy sweating, headache, nausea, dizziness, and irritability can be interpreted as being tired from working in the sun.

    Potential solutions: Make rest and shade breaks mandatory, pre-shift reminders about the symptoms of heat stress, foster a ‘stop and think’ culture, buddy system, make sure employees are aware of the worst-case scenario, and use testimonials and share previous incidents to heighten awareness.

  2. Problem: Don’t understand hydrationDehydration not only leads to heat stress but also impairs visual motor tracking, short-term memory, and concentration leading to work-related accidents. Most workers know that staying hydrated is critical when working in hot and humid environments.

    But “staying hydrated” means different things to different people. To some, it means waiting until they are thirsty to drink. To others, it means grabbing an ice-cold soda loaded with sugar.

    As a general guideline, the recommended amount of water intake is one quart per hour (ideally one cup every 15 minutes) of active work for the average adult. However, every worker is different. Workers with underlying medical conditions or those who are new to the work environment have unique hydration requirements.

    Potential solutions: Have water easily and readily available, provide reusable water bottles, enforce breaks, educate with detailed information about how to hydrate (frequency, water vs.sports drinks, predisposing medical factors, effects of diet, drinking alcohol) and the symptoms of dehydration, and issue frequent reminders and weather alerts throughout the day.

  3. Problem: Inexperienced workersSummer work means many young and inexperienced workers and OSHA statistics prove that these workers are particularly vulnerable to heat-related illnesses. Whether it’s lack of knowledge, an immature attitude, fear, a desire to fit in and prove their worth, or an invincible mindset, some young workers try to side-step an acclimatization program and keep up with more seasoned workers with deadly results.

    Potential solutions: Have a mentoring program, tailor training, establish consequences for failure to follow rules, and consistently interact with workers to gauge how they’re feeling.

  4. Problem: Heat illness mythsEven well-trained employees can fall back on myths, misconceptions, and inaccuracies in the “heat” of the moment. Some common myths are:
    • When you’re having heat stroke, you don’t sweat
    • Acclimatization will protect you during a heat wave
    • Salt tablets are a good way to restore electrolytes lost during sweating
    • Off-duty drinking and diet do not adversely affect the ability to manage job-related heat
    • Medications/health conditions will not affect the ability to work safely in heat

    Potential solutions: To debunk myths, employees need to understand them. Make them a part of ongoing training.

  5. Problem: Bantering and sense of controlBanter is commonplace in many physically demanding jobs. Good-natured joshing and jibing can reduce stress and help to build strong teams. Yet, when bantering moves to rough-and-tumble horseplay or bullying it can lead to dire consequences. When workers are made to feel that needing a break is a sign of weakness – “don’t be a wimp,” “man-up” – a critical line is crossed.

    Potential solutions: How workers perceive the ease or consequences of horseplay or bullying is a key factor. All organizations should make clear what is acceptable and set clear boundaries. Importantly, drill home the message that workers are responsible for each other’s safety and make sure supervisors walk the talk.

For Cutting-Edge Strategies on Managing Risks and Slashing Insurance Costs visit www.StopBeingFrustrated.com

Much needed clarification from OSHA on anti-retaliation provisions

My fellow Certified WorkComp Advisor, Dustin Boss, has allowed me to share his summary of the OSHA anti-retaliation clarification that the U.S. Occupational Health and Safety Administration (OSHA) just issued.

OSHA issued a standard interpretation clarifying its position on the new recordkeeping rule’s anti-retaliation provisions. OSHA’s memorandum essentially “rolls back” its enforcement of the anti-retaliation provisions, particularly concerning safety incentive programs and post-accident drug testing.

Why is this important? Many employers struggled to understand the anti-retaliation provisions since they were published in May 2016 in guidance materials accompanying the new regulations. Up until now, OSHA’s explanations have been extremely vague and confusing. But with this new publication, the confusion ends as the interpretation supersedes all the prior guidance on this topic.

So what changed?

OSHA clarifies that it does not prohibit workplace safety incentive programs or post-incident drug testing. It allows that incentive programs can be an important tool to promote workplace safety and health and encourages programs that reward workers for reporting near-misses or hazards and involvement in a safety and health management system.

OSHA also provides that rate-based incentive programs are permissible under the rule as long as they are not implemented in a manner that discourages reporting. If an employer takes a negative action against an employee under a rate-based incentive program, such as withholding a prize or bonus, or a slice of pizza, because of a reported injury, OSHA will not cite the employer under the anti-retaliation provisions as long as the employer has implemented adequate precautions to ensure that employees feel free to report an injury or illness. It hints that the more “substantial” the reward, then the more the employer may need to do to reassure employees they are free to report without retaliation. In other words, pizza parties are back.

In addition, it states that most instances of workplace drug testing are permissible. Examples of permissible drug-testing include:

  • Random drug testing
  • Drug testing unrelated to the reporting of a work-related injury or illness
  • Drug testing under a state workers’ compensation law
  • Drug testing under other federal law, such as a U.S. Department of Transportation rule
  • Drug testing to evaluate the root cause of a workplace incident that harmed or could have harmed employees. If the employer chooses to use drug testing to investigate the incident, the employer should test all employees whose conduct could have contributed to the incident, not just employees who reported injuries.

What should employers do now?

Employers should keep in mind that the regulations do not mention safety incentive programs or drug testing policies. The discussions about prohibitions on drug testing and incentive programs were included in prior guidance given by OSHA, as is yesterday’s interpretation rolling back that position. Thus, this position could change with the next election. For now, employers have some more certainty that the current OSHA is not going to pursue these types of retaliation claims unless there is some strong indications that the employer took action to discourage reporting.

That said, employers need to remember that the key aspect for determining whether their incentive programs are OSHA “compliant” is to treat all employees in a consistent manner and ensure that employees feel free to report an injury or illness.

Regarding employer drug testing programs, to strike the appropriate balance, drug testing policies should limit post-incident testing to situations in which employee drug use is likely to have contributed to the incident, and for which the drug test can accurately identify impairment caused by drug use.

For additional information, see OSHA’s memorandum entitled, “Clarification of OSHA’s Position on Workplace Safety Incentive Programs and Post-Incident Drug Testing Under 29 C.F.R. § 1904.35(b)(1)(iv).”.

For Cutting-Edge Strategies on Managing Risks and Slashing Insurance Costs visit www.StopBeingFrustrated.com

OSHA watch

Compliance date for parts of general industry beryllium standard delayed

The compliance date for certain ancillary provisions in the beryllium standard for general industry is extended to December 12, 2018. The final rule published in the Aug. 9 Federal Register, states that the compliance date applies to requirements for methods of compliance, beryllium work areas, regulated areas, personal protective clothing and equipment, hygiene facilities and practices, housekeeping, communication of hazards, and recordkeeping.

New compliance assistance resources available for Silica Standard

  • A customizable slide presentation can be used to help train construction workers.
  • A five-minute video shows how to protect workers from exposure to silica dust.
  • A series of short videos demonstrates the proper use of specified dust control methods for six common construction tasks.
  • An FAQ page provides answers to frequently asked questions about the Respirable Crystalline Silica Standard for Construction.

Tips on forklift safety and maintenance

New QuickCards are available in English and Spanish to aid employees and employers in the safe operation and proper maintenance of forklifts.

Guidance explains how to use the 300 log to look for trends

That was no accident encourages employers to use the 300 Log not just as a paperwork exercise or a way to look at past performance, but as part of a company’s road map to finding and fixing hazards.

Redesigned regulations webpage provides easier navigation

The Law and Regulations webpage that features information on standards and rulemaking now can be searched by keyword or number and includes the latest updates on active rulemaking. The page also features information buttons to explain regulatory language that may be unfamiliar to some users.

Free workplace violence prevention webinar available online

A free 60-minute webinar on preventing workplace violence in healthcare settings is available from The Joint Commission, a long-standing national alliance partner. The webinar includes an overview of Guidelines for Preventing Workplace Violence for Healthcare and Social Service Workers, as well as a discussion of a multi-hospital intervention study that reduced violent events.

Name-and-shame strategy still prevalent in news releases

While the rate of releasing public statements about enforcement actions taken against employers is significantly lower under the Trump administration than the Obama administration (463 a year to about 150), the tone in these press releases has not changed. Most include harsh and embarrassing quotations from senior officials. Stakeholders argue that the press releases are based merely on allegations of violations and are published prior to companies being afforded a hearing.

Enforcement notes

California

  • Roofing contractor, Petersen-Dean, Inc., faces $146,004 in fines for repeat violations of exposing workers to fall hazards.
  • New York-based Outfront Media Inc, an outdoor advertising company, faces proposed penalties of $32,435 for serious safety violations after a worker suffered third-degree burns as well as an inadequate heat illness prevention plan for its outdoor workers.

Florida

  • G&H Underground Construction faces $57,738 in proposed penalties for allowing the use of unguarded machines after an employee suffered a throat laceration at a worksite in St. Augustine.
  • Archer Western Construction Inc., an Atlanta-based company, faces $33,259 in proposed fines for safety violations after two employees suffered fatal injuries while performing trenching activities at a Miami worksite.
  • The Holly Hill-based paving company, Pavemax Corp. faces $16,814 in proposed fines for safety violations after an employee suffered fatal injuries at an Orange City worksite, including failure to train and provide a place of employment free from recognized hazards.

Illinois

  • HB Fuller Company, operating as Adhesive Systems Inc., faces $587,564 in proposed penalties for 18 health and safety violations at its facility in Frankfort. The company was cited for failing to: provide employees with respirator fit tests and respirators appropriate for hazardous atmospheres; require bonding and grounding when transferring flammable liquids; ensure that electrical equipment was approved for use in hazardous atmospheres; and conduct a personal protective equipment assessment.

Mississippi

  • After Nissan North America Inc. contested two violations, an administrative law judge of the OSHRC vacated one serious citation but affirmed the other and assessed a $12,675 penalty. The law judge affirmed the violation of training requirements in an employer’s energy control program after determining that the evidence established that the exposure was reasonably predictable and training the technicians was required.

New York

  • The OSHRC affirmed two serious citations previously vacated by an administrative law judge against a commercial laundry facility, Angelica Textile Services Inc., in Ballston Spa. A single grouped penalty of $7,000 was assessed for inadequate isolation and verification procedures for a permit required confined space and of lockout/tagout procedures. However, the review commission reclassified the penalties as serious rather than repeat violations.

Pennsylvania

  • Grove U.S. LLC. was cited for exposing workers to struck-by hazards after three employees suffered fatal injuries when a 300-ton crane collapsed at the company’s Shady Grove facility. The company faces proposed penalties totaling $14,976, the maximum amount allowed.

Tennessee

  • Day & Zimmerman NPS Inc. faces $71,599 in proposed penalties for exposing employees to electric shock hazards at the Tennessee Valley Authority Sequoyah Nuclear Power Plant in Soddy Daisy.
  • Specialty Tires of Unicoi faces $6,000 in fines after a mechanic was killed when he was caught in the moving arms of an assembly machine. The company was cited for failure to have an energy control procedure and failure to conduct regular inspections of an energy control program and ensuring that employees understand and comply with such a program.
  • M&K Home Improvement faces $51,200 in penalties for exposing workers to fall hazards.

For more information.

For Cutting-Edge Strategies on Managing Risks and Slashing Insurance Costs visit www.StopBeingFrustrated.com

The ten most dangerous jobs

While it is generally known that the highest number of workplace fatalities occur among truck drivers and material moving occupations, the chances of a fatality are much higher in specific industries when the fatal work injury rate, calculated per 100,000 full-time equivalent workers, is used. According to a recent report in EHS Today, the ten most dangerous jobs are:

No. 1 – Loggers

The most-dangerous profession, loggers experienced 91 fatalities in 2016 for a fatality rate of 135.9 out of 100,000 workers, an increase of 33% since 2011, when it was ranked number two. Risks: falls, struck-by, dangerous tools such as chainsaws and axes

No. 2 – Fishers and related fishing workers

Fishermen experienced 24 fatalities in 2016 for a fatality rate of 86 out of 100,000 workers, which was a decline of 29% since 2011, when it was ranked number one. Risks: drowning, struck by lightning, crushed by equipment

No. 3 – Aircraft pilots and flight engineers

Pilots and flight engineers experienced 75 fatalities in 2016 for a fatality rate of 55.5 out of 100,000 workers, a slight drop from 2011. Risks: crashes

No. 4 – Roofers

Roofers experienced 101 fatalities in 2016 for a fatality rate of 48.6 out of 100,000 workers, an increase of 50% since 2011. Risks: falls, struck-by, and heat

No. 5 – Refuse and recyclable material collectors

Refuse and recyclable material collectors experienced 31 fatalities in 2016 for a fatality rate of 34.1 out of 100,000 workers, a decrease of 17% since 2011. Risks: dangerous machinery, crushed by equipment, struck-by, traffic accidents, struck by vehicle

No. 6 – Structural iron and steel workers

Steel and ironworkers experienced 16 fatalities in 2016 for a fatality rate of 25.1 out of 100,000 workers, a slight decrease from 2011. Risks: falls, struck-by, heat, crushed by materials

No. 7 – Truck drivers and other drivers

Employees who drive for work – including truck drivers – experienced 918 fatalities in 2016 for a fatality rate of 24.1 out of 100,000 workers, which is similar to 2011. Risks: traffic accidents, struck by vehicle, other drivers, construction zones, sleep deprivation, texting/talking while driving

No. 8 – Farmers, ranchers, and agricultural managers

Agricultural workers experienced 260 fatalities in 2016 for a fatality rate of 23.1 out of 100,000 workers, a slight decline from 2011. Risks: dangerous machinery, chemicals, heat

No. 9 – Supervisors of construction workers

First-line supervisors of construction trades and extraction workers experienced 134 fatalities in 2016 for a fatality rate of 18 out of 100,000 workers. Risks: struck-by, falls at height and on level, heat, use of large equipment

No. 10 – Grounds maintenance workers

New to the list, grounds maintenance workers experienced 217 fatalities in 2016 for a fatality rate of 17.4 out of 100,000 workers. Risks: heat, cold, noise, chemical exposure, ergonomics-related issues, machinery

For Cutting-Edge Strategies on Managing Risks and Slashing Insurance Costs visit www.StopBeingFrustrated.com

Things you should know

Return to work more likely with less-invasive back surgery

A recent study of 364 Ohio workers diagnosed with degenerative spinal stenosis who underwent back surgery found that those who underwent primary decompression, a surgical procedure to alleviate pain caused by pinched nerves, had higher return to work rates than those who had the more-invasive, more-expensive fusion surgery. The study was published in July’s Spine medical journal.


Ohio adopts rule requiring initial conservative back treatment

The Ohio Bureau of Workers Compensation’s new spinal fusion rule requires workers to first undergo at least 60 days of comprehensive conservative care, such as physical therapy, chiropractic care and rest, anti-inflammatories, ice and other non-surgical treatments before lumbar surgery. Conditions that require immediate intervention, such as spinal fractures, tumors, infections and functional neurological deficits, are exceptions to the rule.

DOL will again issue opinion letters on FMLA, FLSA and other laws

The U.S. Department of Labor will again issue opinion letters to assist employers and employees in interpreting laws like the FMLA and Fair Labor Standards Act. The DOL has established a new webpage to submit requests for opinion letters and to review old opinion letters.

New I-9s must be used beginning Sept. 18, 2017

USCIS released a revised version of Form I-9, Employment Eligibility Verification, on July 17. Employers can use this revised version or continue using Form I-9 with a revision date of 11/14/16 N through Sept. 17. On Sept. 18, employers must use the revised form with a revision date of 07/17/17 N. Employers must continue following existing storage and retention rules for any previously completed Form I-9. Changes to the form are considered minor.

Free safe driving kit from National Safety Council

The Safe Driving Kit, sponsored by Wheels, Inc., aims to create safer roads and protect employees through multi-media resources and engaging materials. The kit addresses the key contributors to car crashes, including distraction, alcohol, other drugs, fatigue and seatbelt use. It also brings attention to lifesaving technology that helps prevent crashes.

Workers’ comp making more progress in reducing opioid prescriptions

According to research released by the Centers for Disease Control and Prevention (CDC), the average days’ supply per opioid prescription increased from 13 days in 2006 to almost 18 days in 2015. Meanwhile, nearly half of the states included in a study of opioid prescribing in workers’ compensation cases have seen reductions in the frequency and strength of opioids given to injured workers, according to a study released in June by the Cambridge, Massachusetts-based Workers Compensation Research Institute.

More than 1,000 unsafe CMVs pulled from service during ‘Operation Airbrake’

Brake violations prompted the removal of 1,146 commercial motor vehicles from service as part of a recent unannounced, single-day inspection blitz across the United States and Canada on May 3. According to the Commercial Vehicle Safety Alliance (CVSA), 12 percent of CMVs inspected were taken out of service for brake violations, and 21 percent were removed for other violations.

More than half of workers aren’t trained on first aid, CPR: survey

About 10,000 cardiac arrest situations occur in the workplace each year, yet only 45 percent of U.S. employees have been trained in first aid – and only 50 percent of workers know where to find an automated external defibrillator – according to the results of a survey recently conducted by the American Heart Association.

‘Sleeping in’ on weekends may be bad for your health: study

Going to bed later and waking up later on weekends than during the week – also known as social jet lag – may be linked to poor health and higher levels of sleepiness and fatigue, according to the preliminary results of a study conducted by researchers at the University of Arizona. Results showed each hour of social jet lag was linked to an 11.1 percent increase in the chances of developing heart disease. In addition, participants who experienced social jet lag were 28.3 percent more likely to report their health as “fair/poor.” The study abstract was published in an online supplement to the journal Sleep.

Safety measures lacking on plastic injection molding machines, peripheral equipment: study

Factories with plastic injection molding machines that interact with peripheral equipment – such as robots or conveyors – could do more to improve safety, Canadian scientific research organization IRSST concluded in a recent study. The study was published in May along with a technical guide.

State news

New rule requires preauthorization of all compounds, regardless of price – Florida

  • To clear up a “misunderstanding” among stakeholders, the Florida Division of Workers’ Compensation has clarified that all compounded drugs, regardless of cost, are now subject to preauthorization.

Legislators pass budget without workers’ comp reform – Illinois

  • While the state faces one of the highest workers’ compensation insurance rates in the country, legislators were unable to reach a consensus on reforms.

Prescription drug monitoring program implemented – Missouri

  • Missouri was the only state that lacked a prescription drug-monitoring program prior to last month when the governor signed an executive order directing the Department of Health and Senior Services to create a prescription drug-monitoring program.

Workers’ comp rules tightened – Missouri

  • The new legislation redefines “maximum medical improvement (MMI)” as the point when the condition of an injured employee can no longer improve, and bans any claims for benefits beyond that time period. It also puts more emphasis on the employee proving an employer discriminated against them after they filed a workers’ compensation case.

4.5% decrease in workers’ comp for businesses – New York

  • The New York Department of Financial Services has approved the 4.5% workers compensation premium rate decrease recommended by the New York Compensation Insurance Rating Board effective Oct. 1.

For Cutting-Edge Strategies on Managing Risks and slashing Insurance Costs visit www.StopBeingFrustrated.com

Things you should know

Employer control over medical providers can lower costs for spinal injuries

A study by the Workers Compensation Research Institute (WCRI) found the greatest disparity in medical and indemnity costs between states that allow injured workers to choose their own providers and those that give employers more control is for spinal injuries. Researchers noted that there is more subjectivity in the nature of care for back and neck injuries, whether employees can go back to work, and the level of pain.
ISEA updates fall protection guide

In response to new regulations and standards, the International Safety Equipment Association (ISEA) has updated its Personal Fall Protection Equipment Use and Selection Guide. The 30-page document explains how to set up a fall protection program, details the major parts of fall protection systems, and advises on the selection of equipment based on industry. It also includes relevant OSHA regulations and U.S. and Canadian consensus standards.
New chronic pain guideline emphasizes physical activity

An “overwhelming theme” in treating patients for chronic pain is to keep them as physically active as possible, according to an American College of Occupational and Environmental Medicine treatment guideline recently released, which has not been released to the public. The therapy needs to move beyond simply stretching to strengthening, aerobic conditioning, and functional improvement and one key is to not prescribe activity “as tolerated” or “as needed.”
Study of severe injury data finds poultry and meat workers at high risk

Every day, 27 workers suffer on-the-job amputations or injuries that require hospitalization, according to a recent report from the National Employment Law Project. According to the data, employers reported 17,533 severe injuries between Jan. 2015 and Sept 2016.

Out of more than 14,000 companies reporting to the government, Tyson Foods ranked fourth, and JBS/Pilgrim’s Pride ranked sixth, in terms of the number of severe injury reports filed. Further, the poultry industry as a whole has the 12th highest number of severe injuries of all industries reporting-higher than the sawmill industry, auto, steel, and other high-hazard industries.
Large variation in worker attorney involvement by state: study

WCRI released a new FlashReport to help inform policymakers and stakeholders about worker attorney involvement in their state. According to the study, the percentage of claims with worker attorneys ranged from 13-14 percent in Wisconsin and Texas to 49-52 percent in New Jersey and Illinois. States included in this study are Arkansas, California, Florida, Georgia, Illinois, Indiana, Iowa, Kentucky, Louisiana, Massachusetts, Michigan, Minnesota, New Jersey, North Carolina, Pennsylvania, Texas, Virginia, and Wisconsin.
Mine safety rule implementation delayed until Oct. 2

The U.S. Mine Safety and Health Administration (MSHA) has extended the effective date for its rule on workplace safety examinations for metal and nonmetal mines to Oct. 2. The rule addresses the timing of workplace safety examinations and strengthens notification requirements.
MSHA launches lone miner safety initiative

MSHA announced it will begin focusing inspections and mine visits on lone miner situations after five of eight miner fatalities this year have involved miners working alone.
State updates

California

  • Insurance Commissioner Dave Jones has issued a revised advisory pure premium rate, reducing rates by 16.5% to $2.02 per $100 of payroll effective July 1.
  • Occupational Safety and Health Standards Board approved a new regulation that serves to strengthen process safety management around the state’s oil refineries.
  • The start date for the planned drug formulary will be delayed by six months to January 1, 2018 to revise parts of the plan and receive public comments.

Florida

  • 14.5% increase in comp premiums upheld by appeals court.

Illinois

  • The average indemnity benefit per claim in Illinois was $21,275 in 2013, while the median state benefit per claim was $18,269 according to a WCRI study.
  • The Senate passed two pieces of workers compensation reform legislation that would reduce the cost of workers compensation insurance for employers and introduce market competition. The bills will be sent to the governor for signature.

Mississippi

  • The Workers’ Compensation Commission has adopted an amendment to its 2017 fee schedule, adding opioid guidelines.

 

 For Cutting-Edge Strategies on Managing Risks and slashing Insurance Costs visit www.StopBeingFrustrated.com

Things you should know

Attention motor carriers: “Roadcheck” annual event – June 6 – 8

Nearly three times more roadside inspections take place during the 72 hours on June 6 – 8 than on any other time of the year. Sponsored by the Commercial Vehicle Safety Alliance (CVSA), the intensive annual “Roadcheck” is a good opportunity for those in the motor carrier industry to improve their Compliance, Safety, Accountability (CSA) scores. In 2016, 62,796 truck and bus inspections were completed throughout the United States, Canada, and Mexico.

Top construction risks: geopolitical instability, workforce management issues

In a survey of executives in the construction sector, Willis Towers Watson P.L.C. found geopolitical instability and workforce management issues as the biggest challenges facing the industry. Geopolitical issues included uncertainty of government support and financing, postponement and delays, changes in strategy, and commitment to project pipelines. Workforce management issues include increasing need for digital skills, a global employee network, disparate labor laws, difficulty to attract talent, and an aging population. The Construction Risk Index report can be downloaded here.

New pamphlet spotlights Hypothenar Hammer Syndrome

Scientific research organization IRSST has released a pamphlet intended to help workers recognize Hypothenar Hammer Syndrome. Aimed at workers who use vibrating tools or frequently strike, press or twist objects with the palms of their hands, the free pamphlet outlines syndrome warning signs and prevention methods.

Mayo Clinic study: second opinion leads to new or refined diagnosis for 88% of patients

Many patients come to Mayo Clinic for a second opinion or diagnosis confirmation before treatment for a complex condition. In a new study, Mayo Clinic reports that as many as 88 percent of those patients go home with a new or refined diagnosis – changing their care plan and potentially their lives. Conversely, only 12 percent receive confirmation that the original diagnosis was complete and correct.

These findings were published online in the Journal of Evaluation in Clinical Practice.

Study links participation in weight-loss programs to reduced absenteeism

Obese workers who took part in a structured weight-loss program reported fewer hours missed on the job after six months, a recent University of Michigan study shows.

Researchers surveyed 92 people who had an average body mass index of 40 and worked in various occupations. Before entering the program, participants stated in a self-evaluation that they worked an average of 5.2 fewer hours a month than their employers expected. After six months and an average of 41 pounds shed, participants reported working 6.4 more hours a month than expected.

WCRI’s CompScope™ Benchmark 2017

The 17th edition of CompScope™ Benchmarks Report is available from the Workers’ Compensation Research Institute (WCRI). The report looks at the impact of state workers’ compensation reforms on things like claim costs, rate of litigation, and disability duration and included 18 states: California, Florida, Georgia, Illinois, Indiana, Kentucky, Louisiana, Massachusetts, Michigan, Minnesota, New Jersey, North Carolina, Pennsylvania, Texas, Virginia and Wisconsin. In California and North Carolina, the total costs per claim have been steady between 2010 and 2013. Illinois saw total costs per claim decrease by 6.4 percent since 2010, which researchers attribute to a 30 percent reduction in fee schedule rates for their medical services. Indiana’s total costs per claim decreased by 4 percent from 2014 to 2015, a product of a 10 percent decrease in medical payments, but a 5 percent increase in indemnity benefits per claim. In Florida, total costs per claim increased between 2010 and 2015, but there were decisions last year from the Florida Supreme Court that may slow or stop those increases in costs.

Rising pedestrian death toll

The latest report on U.S. pedestrian deaths, from the Governors Highway Safety Association, estimates that last year’s total rose 11.6 percent to nearly 6,000, or more than 16 fatalities a day. If that projection proves accurate – it is based on fatality records from only the first half of 2016 – it would mark the sharpest yearlong increase since records have been kept.

Analysts are putting much of the blame on drivers and walkers who are looking at their smartphones instead of watching where they are going. Tipsy walking also is part of the problem, with one in three victims legally drunk when they were struck and killed.

Workplace death rate hits a 10-year high in Massachusetts

Seventy Massachusetts workers lost their lives last year, marking a 10-year high in the rate of workplace-related fatalities, according to the Massachusetts Coalition for Occupational Safety and Health, known as MassCOSH. Sixty-two of those workers were killed on the job, many in construction; the rest were firefighters who died from occupational illnesses, such as lung cancer and heart disease.

For Cutting-Edge Strategies on Managing Risks and slashing Insurance Costs visit www.StopBeingFrustrated.com

Legal Corner

ADA
EEOC settles first direct challenge to employer wellness program

The EEOC’s first lawsuit directly challenging an employer’s wellness program-filed in 2014- was against Orion Energy Systems. The company had switched to a self-insured plan and, to save costs, initiated a wellness plan that revolved around three incentives: the employee did not smoke, would exercise 16 times a month, and have a health risk assessment (HRA). There were surcharges for non-compliance, including paying the entire monthly premium if they did not have a HRA, which was $413.43 for single, $744.16 for limited family, and $1,130.83 for family coverage.

One employee raised concerns about the wellness initiative and HRA, questioning confidentiality and how the premium was calculated believing it excessive in light of the service fee Orion paid its third-party administrator (she knew the amount because she paid invoices). She opted out of the program and agreed to pay the premium. However, her supervisor and the HR director spoke to her about comments she made to coworkers about the premium, telling her such negativity was not welcome, and to keep her opinions to herself and eventually she was terminated.

While the court found that Orion’s wellness plan was lawful under the regulations at the time, there were issues of fact as to whether the employee was fired because of her opposition to the wellness plan. Under the consent decree settling the suit, Orion agreed to pay $100,000 to the employee and agreed that it won’t maintain any wellness program in the future that poses disability-related inquiries or seeks a medical examination that is not voluntary within the meaning of the ADA and its regulations as well as other provisions.

FMLA
Inadvisable email negates defense to FMLA retaliation claim

An employee at Wells Fargo received an informal and then a formal warning about underperformance and her failure to meet sales goals. One week prior to receiving the formal warning, she was diagnosed with myelopathy, scheduled for surgery, and received FMLA leave. When she returned to work on limited duty, her supervisor warned her that she was still near termination. After her return to full duty, her supervisor determined she had not made sufficient improvement and he documented the problems in an email to the HR department and recommended termination. In this email, he also noted, “Debby submits a request for a leave of absence.”

The employee sued for retaliatory discharge under the FMLA and the federal court found that the email comment about the request for a leave of absence as part of the email justifying discharge was direct evidence of unlawful retaliation. Although Wells Fargo could document the underperformance and warnings, the court concluded for summary judgment motions in cases involving direct evidence of discrimination, an employer’s legitimate, nondiscriminatory business reason for an adverse employment action is irrelevant.

Takeaway: Electronic communications have permanency. Be sure supervisors and managers understand the importance of their choice of words and know what should and should not be included in recommendations for termination.

Temporary work counts as a factor when determining FMLA eligibility

In Meky v. Jetson Specialty Mktg. Servs. Inc., a temporary employee was hired through a staffing agency for about six months and then was hired to work full-time. She requested FMLA, but was told she was not eligible and was terminated a few months later for leaving work early. She sued and one question the court had to decide was the start date of her employment. The 3rd U.S. Circuit Court of Appeals held that the correct date was the date on which she started working as a temporary employee, since the staffing agency and the Jetson were joint employers.

Workers’ Compensation
Finding of compensable injuries to knee and shoulder does not bar later additional claim related to back – California

In Iniguez v. WCAB (Blue Rose Concrete Contractors), a worker was compensated in 2012 for injuries to his knee and shoulder stemming from an accident in 2010. In November 2014, he filed another claim seeking additional benefits for injuries to the neck and back. The WCAB found that compensation should be limited to the knee and shoulder in accordance with the 2012 litigation, but the 2nd District Court of Appeals annulled the board’s decision by saying there was no finding that these were the only industrial injuries sustained and remanded the case for further proceedings.

Vacation and sick time not earned income when calculating impairment benefits – Florida

In Eckert v. Pinellas County Sheriff’s Office, the employer reduced the injured worker’s benefits by 50% for the 23 weeks he used his sick leave and vacation time, arguing that this was allowed as “earned income” under state law. However, the 1st District Court of Appeal said use of sick leave and vacation time could not count toward his average weekly pay for the 23 weeks in question, since sick leave and vacation time were not accrued during the weeks that he drew upon so it was not “earned income.”

“Heart attack waiting to happen” leads to denial of claim – Illinois

A firefighter described, as “a heart attack waiting to happen” should not receive benefits for a heart attack sustained while cleaning his firehouse parking spot of snow ruled an appellate court. The firefighter was a heavy smoker, obese, and had so many risk factors for a heart attack that the cardiac event could have occurred “anytime and anywhere,” said the arbitrator. Those risk factors were enough to overcome the statutory presumption that heart attacks suffered by firefighters are a compensable injury.

Fired for misconduct, employee can still collect benefits – Indiana

In Masterbrand Cabinets v. Waid, a worker who injured his back disagreed with his doctor and supervisor about his level of pain and work capacity. An incident with the supervisor escalated to an altercation. He was suspended and then terminated. He continued to see the doctor and the Workers’ Compensation Board found he was unable to perform work of the same kind he was performing when injured and that he was due TTD payments. The company appealed, arguing the worker was not entitled to TTD benefits because he was terminated for misconduct. However, the Court held that the inability to work was related to his injury and, therefore, he was entitled to benefits.

Statute of limitations not valid defense when injured employee was promised action – Mississippi

An employer and its carrier cannot argue the statute of limitations as a defense when the carrier had assured the injured employee that it would “take care of everything” and there was no need for her to hire an attorney. Moreover, the carrier had paid for medical expenses three days after the expiration. Dietz v. South Miss. Reg’l Ctr.

Long history of medical problems does not preclude PTD for shoulder injury – Missouri

In Maryville R-II School District v. Payton, a school groundskeeper with a history of ailments and multiple surgeries went to the emergency room when he started to have serious shoulder pain after assembling a soccer goal. An X-ray did not reveal any acute fracture or dislocation, and an emergency room doctor tentatively diagnosed him with osteoarthritis. He then saw the school district’s physician who opined that the activity was unlikely to be the prevailing cause of the pain. He then sought treatment from his own physician and an MRI revealed a rotator cuff tear. Surgery was performed but the rotator cuff tore again and he was unable to return to work because the school district could not accommodate his lifting restrictions.

A judge, the Labor and Industrial Relations Commission, and the Court of Appeals all concurred that the injury was permanent and totally disabling.

Tort suit for worker’s heat-related death revived – Missouri

In Channel v. Cintas Corp., a 52-year-old delivery driver died of heat stroke and his widow filed a wrongful death action against the supervisor and the company. She argued that the supervisor ignored the company’s heat safety protocols by placing her husband in a truck without air conditioning on a day when temperatures were over 100 degrees. While a circuit judge ruled that workers’ comp was the only remedy, the Court of Appeals ruled that the Labor and Industrial Relations Commission had not yet ruled on the workers’ comp case and it was improper for the judge to determine that the death was an accident. The suit was reinstated and placed on hold.

Symptoms of heart attack at work not sufficient for death benefits – New York

In the Matter of Bordonaro v Genesee County Sheriff’s Office, a deputy sheriff died at home in his sleep and his widow sought workers’ comp death benefits, contending his initial symptoms occurred at work. Noting the employee had completed his shift and had not sought medical treatment, the appellate court supported the Board’s finding that the death was not casually connected to work.

Benefits denied in two stress related cases – New York

In Matter of Novak v St. Luke’s Roosevelt Hosp., a New York appellate court affirmed a Board finding that a nurse’s work-related stress did not exceed what could be expected in her normal work environment. It was determined that her stress stemmed from her involvement in a disciplinary proceeding, wrongful termination, and subsequent reinstatement after a six-month suspension. She complained about her treatment by co-workers when she returned to work, eventually quit her job, and filed a comp claim asserting the events caused insomnia, depression, posttraumatic stress disorder, and a severe social phobia. The claim was disallowed and the appellate court noted claims for mental injuries based on work-related stress are precluded “if such mental injury is a direct consequence of a lawful personnel decision involving a disciplinary action, work evaluation, job transfer, demotion or termination taken in good faith by the employer.”

In Burke v. New York City Transit Authority, a subway train operator was denied a psyche claim for harassment from his supervisors. The employee wears glasses, has a sensitivity to light, and has tinted lenses he can flip down over his glasses. Train operators are prohibited from wearing sunglasses for safety reasons, and the employee was being monitored to ensure that he was not wearing his tinted lenses while operating a train. He claimed his supervisors harassed and intimidated him about the lenses, causing him to develop disabling anxiety and panic attacks. The courts determined that the stress created by the investigation was not greater than that which other similarly situated workers experienced in normal work and, therefore, it was not compensable.

Benefits granted for ‘reasonable effort’ for employment – North Carolina

For a worker to receive benefits in the state, it must be shown that the worker was not capable of earning the same money as before the injury due to the injury. In Snyder v. Goodyear Tire & Rubber Co., a tire builder suffered a back injury and returned to work with lifting restrictions. However, the employer was not able to accommodate the restrictions and sent him home. He filed for workers’ comp and the commission found that he met the burden for temporary total disability by proving he could not return to his pre-injury job and had made unsuccessful attempts to obtain employment.

While the company appealed, arguing that the employee had not made reasonable efforts for employment, the appeals court disagreed. The court did note that an employer’s failure to provide light duty work in and of itself is not proof that an injured employee made a reasonable but unsuccessful effort to find employment.

Decision in Heart and Lung claim not binding on workers’ comp – Pennsylvania

A prison guard trainee hurt his knee and filed for benefits under the Heart and Lung Act (H & L Act), which allows certain police officers and other public safety employees to collect full salary and medical benefits for temporary injuries. An arbitrator determined he was eligible for benefits. He later filed a claim for workers’ comp, but the judge found he was entitled to medical benefits, but not disability benefits because he failed to prove a loss of wages.

The guard appealed arguing his disability was established under the H & L Act, but the court noted the laws were quite different and the Workers’ Comp Act could provide significantly greater medical and indemnity benefits, including those for permanent impairment. Therefore, a decision by an arbitrator in an H & L claim filed by a corrections officer was not binding on the workers’ compensation judge. Merrell v. Workers’ Comp. Appeal Bd. Commonwealth Dep’t of Corr.

Non-payment of PT benefits leads to penalties in spite of billing dispute – Pennsylvania

An employee of Derry Township Supervisors received PT for a back and neck injury at a facility owned by The pt Group. The bills, however, came from the Physical Therapy Institute (PTI), which had a contractual arrangement with The pt Group. The Derry Township argued this arrangement was a way to charge higher fees.

As of Jan. 1, 1995, providers are able to bill comp carriers at 113% of the rate established by the Centers for Medicare & Medicaid Services fee schedule, but the Supervisors alleged that providers in business before that date can use a “cost-plus” formula that generally means a higher payment. The pt Group was subject to the 113% cap, but PTI was not.

The Commonwealth Court upheld lower court decisions that there was nothing illegal in this arrangement and ordered an award of $83,400 in attorney fees, and reimbursement of $3,328.32 for litigation costs.

Opioid overdose after injury not compensable – Tennessee

A carpenter was involved in an employment-related motor vehicle accident that caused fractures to the vertebrae in his neck and disc herniation in his lower back. He underwent surgery, but continued to have back pain and further surgeries were denied, as were epidural steroid injections. He was referred to a pain management clinic and restricted from returning to work.

He told the pain management specialist that he began taking extra opioid tablets and consumed alcohol because he felt the medications were no longer effective. Shortly after agreeing to a program to wean off the drugs, his wife found him unresponsive in bed. The medical examiner ruled his death an accident caused by acute oxycodone toxicity with contributory causes of hypertension and alcohol and tobacco use.

His wife filed with workers’ comp benefits and the case went through appeals and ultimately was heard by the state Supreme Court. In Judy Kilburn vs. Granite State Insurance Company, et al., the Supreme Court noted that a worker’s conduct can limit compensability of subsequent injuries that are a direct and natural result of a compensable primary injury and ruled his death not compensable because he failed to take his medications in compliance with physician’s orders.

Disagreement over diagnosis not sufficient to rebut correctness of impairment rating – Tennessee

In Williams v. Ajax Turner Co., an employee was assigned a 21.3% impairment rating from his doctor following surgery of his foot after a forklift accident. The employer requested a second opinion from an orthopedic surgeon who assigned a 5% impairment rating, and a third opinion through the medical impairment registry (MIR) program, which also resulted in a 5% rating. A trial judge accepted the treating doctor’s rating and applied a multiplier of 4.

The Supreme Court’s Special Workers’ Compensation Appeals Panel said an MIR physician’s rating is presumed to be accurate, unless this can be overcome by clear and convincing evidence giving rise to a “serious and substantial doubt” about the accuracy of the rating. A disagreement about the rating, however, is not clear and convincing evidence; therefore, the MIR rating should have been accepted. It also agreed to the multiplier of 4, given considerations of education, job skills, work history, and medical limitations so the award of permanent disability benefits had to be modified to 20%.

For Cutting-Edge Strategies on Managing Risks and slashing Insurance Costs visit www.StopBeingFrustrated.com